Park M J, Ahn J H, Kang J S
Department of Orthopaedic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Bone Joint Surg Br. 2003 Sep;85(7):1011-5. doi: 10.1302/0301-620x.85b7.14195.
We analysed the results of arthroscopic synovectomy of the wrist in 18 patients (19 wrists) with rheumatoid arthritis who had not responded to conservative treatment. The patients' symptoms were assessed using visual analogue scales for pain and satisfaction. Standard posteroanterior radiographs which were taken pre-operatively and at final follow-up were analysed using a modified Larsen scoring system (normal, 0; total destruction, 40). The mean follow-up period was 29.2 months (24 to 45). The mean pre-operative pain score was 8.58 which decreased to 3.58 one year after surgery and increased again to 4.42 at final follow-up. This suggested a gradual increase in pain with time. The mean satisfaction score was 6.26. The mean modified Larsen's score was 9.8 pre-operatively and 13.9 at final follow-up, which demonstrated the slow progression of degenerative changes. Arthroscopic synovectomy for rheumatoid arthritis of the wrist allows effective pain relief and high patient satisfaction, although any prolonged benefits will require long-term follow-up.
我们分析了18例（19个手腕）类风湿性关节炎患者接受腕关节镜下滑膜切除术的结果，这些患者对保守治疗无反应。使用视觉模拟量表评估患者的疼痛和满意度症状。术前和最终随访时拍摄的标准正位X线片采用改良的拉森评分系统进行分析（正常为0；完全破坏为40）。平均随访期为29.2个月（24至45个月）。术前平均疼痛评分为8.58，术后一年降至3.58，最终随访时再次升至4.42。这表明疼痛随时间逐渐增加。平均满意度评分为6.26。术前改良拉森评分平均为9.8，最终随访时为13.9，这表明退行性变进展缓慢。腕关节类风湿性关节炎的关节镜下滑膜切除术可有效缓解疼痛并提高患者满意度，尽管任何长期益处都需要长期随访。
